학술논문

Sex-Differences in Atrial Fibrillation Patients: Bias or Proper Management?
Document Type
Academic Journal
Source
Vascular Health and Risk Management. May 31, 2022, Vol. 18, p347, 12 p.
Subject
Israel
Language
English
ISSN
1178-2048
Abstract
Background: Studies analyze the degree to which gender-based differences are affected by age and comorbidities show mixed results. Methods: Using a retrospective cohort study, we analyzed 327 consecutive patients who presented to the emergency department (ED) due to Atrial Fibrillation (AF) from 2014 to 2017 with follow-up at one year Results: Females with AF were older (p < 0.001), with higher Body Mass Indexes (BMI) (p < 0.001), and a higher rate of hypertension (p < 0.001), hyperlipidemia (p = 0.01), diabetes mellitus (p = 0.05), valvular heart disease (p = 0.05), and thyroid dysfunction (18.3% vs 1.8%, p < 0.001). AF males had higher rate of coronary artery disease (p < 0.001) and heart failure with reduced ejection fraction (p < 0.001). Females were managed with rate control medications more frequently than with antiarrhythmic (p < 0.001). After adjusting gender to age and comorbidities, females continued to have higher rates of heart failure hospitalization (Odds Ratio (OR) 2.73 95% Confidence Interval (CI) 1.04-5.89, P-value Conclusion: AF males and females differ significantly in baseline characteristics and tend to be treated unnecessarily differently for AF. Heart failure hospitalizations and recurrent AF continued to be associated with female AF patients, even after adjusting gender to age and comorbidities. Thyroid dysfunction and AF treatment may explain the higher rates of recurrent AF in female patients. Keywords: atrial fibrillation, cardioversion, emergency department, MACE, rate control, rhythm control, survival outcomes
Introduction Atrial fibrillation (AF) is a worldwide epidemic, (1) with estimates predicting it will affect up to 12 million patients in the USA by 2050 and up to 17.9 million [...]